Favorable Outcomes After Liver Transplantation With Normothermic Regional Perfusion From Donors After Circulatory Death: A Single-center Experience

Ruíz, P.; Gastaca, Mikel; Bustamante, Francisco Javier; Ventoso, A.; Palomares, I.; Prieto, Mikel; Fernández, José R.; Salvador, Pablo; Pijoán, José Ignacio; Valdivieso, A.

doi:10.1097/tp.0000000000002391

Cited by 62 publications

(68 citation statements)

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“…This is a better light in which to judge our results. We also point out that our results are similar to a cohort of elderly, non-DCD donors reported in international registries 3,4 (Table 1). We believe that our actual data fit within the range of good clinical practice standards.…”

supporting

confidence: 90%

“…We would like to emphasize the high pressure of the waiting list in our hospital, a pioneering liver transplant center in Spain (1988), with the highest indication rate of liver transplantation per million of population in our country. 3 Our liver transplantation program receives patients for liver transplantation from other regions, also for second opinions. This waiting-list pressure has pushed us to expand our pool of donors, both donation after brain death and DCD, raising the age limit during donor selection to overcome this problem.…”

mentioning

confidence: 99%

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Response to “Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again”

Cascales-Campos

Ferreras

Alconchel

et al. 2020

American Journal of Transplantation

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confidence: 90%

mentioning

confidence: 99%

Response to “Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again”

Cascales-Campos

Ferreras

Alconchel

et al. 2020

American Journal of Transplantation

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“…It also allows assessment of organ function prior to transplantation, assisting in the optimal selection of grafts to maximize posttransplant outcomes, particularly in cDCD liver and heart transplantation [64]. Although the experience of using nRP in cDCD is still limited, published series support these theoretical benefits and report promising results in terms of numbers of organs recovered and transplantation outcomes [65][66][67]. nRP also seems to allow a safe expansion of donor age, a factor which has classically been a major determinant of recipient outcomes [68].…”

Section: Normothermic Regional Perfusionmentioning

confidence: 99%

Organ donation after circulatory death: current status and future potential

et al. 2019

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The continuing shortage of deceased donor organs for transplantation, and the limited number of potential donors after brain death, has led to a resurgence of interest in donation after circulatory death (DCD). The processes of warm and cold ischemia threaten the viability of DCD organs, but these can be minimized by well-organized DCD pathways and new techniques of in-situ organ preservation and ex-situ resuscitation and repair post-explantation. Transplantation survival after DCD is comparable to donation after brain death despite higher rates of primary non-function and delayed graft function. Countries with successfully implemented DCD programs have achieved this primarily through the establishment of national ethical, professional and legal frameworks to address both public and professional concerns with all aspects of the DCD pathway. There remains a worldwide shortage in organ availability, and it seems unlikely that expanding standard DCD programs in isolation will be sufficient to address this. It is therefore likely that reliance on extended criteria donors will increase, with the attendant imperative to minimize ischemic injury to candidate organs. Normothermic regional perfusion and ex-situ perfusion techniques allow enhanced preservation, assessment, resuscitation and/or repair of damaged organs as a way of improving overall organ quality and preventing the unnecessary discarding of DCD organs. This review will outline exemplar controlled and uncontrolled DCD pathways, highlighting practical and logistical considerations that minimize warm and cold ischemia times while addressing potential ethical concerns. Future perspectives will also be discussed. Take home message Donation after circulatory death (DCD) is an effective means of expanding the potential donor pool, and has comparable transplantation survival to donation after brain death despite higher rates of primary nonfunction and delayed graft function. Countries with successfully implemented DCD programs have achieved this primarily through the establishment of national ethical, professional and legal frameworks to address both public and professional concerns with all aspects of the DCD pathway.

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“…3 Moreover, our experience in Bilbao with the use of NRP in controlled DCD LT has been recently published. 5 After a median follow-up of 19 months, 1-…”

Section: Data From the Reth Show 1-year Graft Survival Over 90% In Ourmentioning

confidence: 99%

Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again

Gastaca

Ruíz

Bustamante

et al. 2020

American Journal of Transplantation

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Favorable Outcomes After Liver Transplantation With Normothermic Regional Perfusion From Donors After Circulatory Death: A Single-center Experience

Abstract: As far as we know, this represents the largest published series of cDCD LT with NRP preservation. Our results demonstrate that cDCD liver grafts preserved with NRP appear far superior to those obtained by the conventional rapid recovery technique.

Cited by 62 publications

References 24 publications

Response to “Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again”

Response to “Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again”

Organ donation after circulatory death: current status and future potential

Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again

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